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chief concerns richard marinucci
Ever since the fire service got into the ambulance/rescue business, it has been looking for the perfect vehicle to use.
As of now, there is no one such vehicle that will be applicable to all organizations and all situations. Some departments use paramedic engines while others use smaller response vehicles while still others have tried out sport utility vehicles. Some only worry about the transport portion, and some have some basic capabilities for firefighting as their personnel are needed for fire response. This might even include some hose and a little tank water. One will also find organizations with distinct delineations of responsibilities so fire trucks do fire work and ambulances take care of emergency medical services (EMS).
Fit the Mission
Fire departments need to look at their mission, goals, and objectives. They need to evaluate their resources and the services expected of them. While there is always value in considering what others are doing, you do not need to “keep up with the Joneses” regarding your vehicle. You need to get what is good for your system and service as you consider the finances available for your use. Besides the cost, contemplate specifics for your department and personnel such as training, drivability (your road system and congestion so you can negotiate traffic, streets, and parking lots), maintenance, weight, and safety.
EMS can be provided in a variety of ways and with variances in many methods. In a perfect world, there might be carbon copies, but like much of the fire service, there are differing opinions for what is the best system. Each community gets to make its choice. Hopefully, it is an informed decision so it selects the best method. We know that departments can choose not to be involved in EMS, but this is more the exception to the rule. Organizations have the option of medical first responder level, basic emergency medical technician, or paramedic service (though there are some intermediates scattered about). They can choose to transport or not or be backup for true emergencies. They can have a governmental third service or private support through a hospital-based system or a private ambulance company. Depending on your system, your vehicle should be commensurate with your delivery model.
Vehicles
Departments have enjoyed successes with many types of vehicles and are often committed to their approach. As such, they will “brag” about their approach. They may be believers in remounts or basic “van-type” vehicles that are relatively inexpensive and disposable. On the other side of the argument are more heavy-duty vehicles that cost more but offer the advantages of a larger, more durable vehicle. One could make the case that there are successes in each approach, and service delivery and quality are in line with the expectations of the community. Those decisions are made locally but should not be made in a vacuum. Those who ultimately make the decision need to know the advantages and disadvantages. While cost is certainly a factor, it needs to be weighed against the desired quali